Surgical Risk in Distressed or Underserved Populations

This chapter synthesizes what is known about the impact of social determents of health (SDOH) on the outcomes of high-risk surgeries within the fields of cardiothoracic and vascular surgery, trauma surgery, and surgical oncology. SDOH are nonmedical factors that influence health outcomes and include economic stability, neighborhood, healthcare access and quality, race and ethnicity, and education access and quality. There is clear data showing worse surgical outcomes particularly based on race and economic status. However, SDOH are difficult to research as they are inherently personal to the individual. Thus, current research has not identified specific determinants that may be easily addressed by the independent provider. The following chapter will discuss what determinants have been identified and present several possible solutions that the individual provider may consider. Focus is given to possible solutions such as a surgeon’s opportunity to address lifestyle modification and the importance of advocating for systemic change.